Functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgery

Abstract Background Degenerative cervical myelopathy (DCM) represents a prevalent etiology of neurological dysfunction, for which cervical decompression surgery (CDS) constitutes the principal therapeutic intervention. Advanced magnetic resonance imaging (MRI) techniques are crucial in elucidating t...

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Main Authors: Bingyong Xie, Haoyu Ni, Jiyuan Yao, Zhibin Xu, Sicheng Bian, Haoxiang Wang, Kun Zhu, Xianyong Wu, Peiwen Song, Yuanyuan Wu, Yongqiang Yu, Fulong Dong
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00909-4
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author Bingyong Xie
Haoyu Ni
Jiyuan Yao
Zhibin Xu
Sicheng Bian
Haoxiang Wang
Kun Zhu
Xianyong Wu
Peiwen Song
Yuanyuan Wu
Yongqiang Yu
Fulong Dong
author_facet Bingyong Xie
Haoyu Ni
Jiyuan Yao
Zhibin Xu
Sicheng Bian
Haoxiang Wang
Kun Zhu
Xianyong Wu
Peiwen Song
Yuanyuan Wu
Yongqiang Yu
Fulong Dong
author_sort Bingyong Xie
collection DOAJ
description Abstract Background Degenerative cervical myelopathy (DCM) represents a prevalent etiology of neurological dysfunction, for which cervical decompression surgery (CDS) constitutes the principal therapeutic intervention. Advanced magnetic resonance imaging (MRI) techniques are crucial in elucidating the cerebral alterations associated with neuroinjury resulting from DCM. Methods In this prospective cohort study, we conducted an analysis of data from 54 patients with DCM both before and after surgery, as well as 57 healthy controls (HC), using functional MRI in combination with high-resolution structural MRI. The primary metrics included the z score transformation amplitude of low-frequency fluctuations (zALFF), functional connectivity (FC), and gray matter volume (GMV). Neurological function was evaluated through standardized clinical scores. Statistical analyses were employed to compare preoperative and postoperative changes, as well as to examine correlations with patient recovery outcome. Results Here we show that DCM patients exhibit significant preoperative alterations in zALFF, FC, and GMV within critical brain regions associated with sensory processing, motor control, and cognitive integration. Postoperatively, an increase in zALFF within Postcentral_R region, along with increased FC with motor-related areas, which correlates positively with neurological recovery. Moreover, GMV shows a widespread reduction before and after surgery. Conclusions Our study reveals functional alterations within the brain are closely associated with effective surgical recovery, especially concerning the remodeling of the ascending and descending pathways along the brain–spinal cord axis. Moreover, macrostructural changes manifest more gradually, with the recovery of brain function depending more on compensation and remodeling within neural networks than solely on structural restoration.
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spelling doaj-art-629811fa8bed4fb593c9d1bfc772d9cd2025-08-20T01:53:15ZengNature PortfolioCommunications Medicine2730-664X2025-05-015111310.1038/s43856-025-00909-4Functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgeryBingyong Xie0Haoyu Ni1Jiyuan Yao2Zhibin Xu3Sicheng Bian4Haoxiang Wang5Kun Zhu6Xianyong Wu7Peiwen Song8Yuanyuan Wu9Yongqiang Yu10Fulong Dong11Department of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Spine Surgery, Anqing First People’s HospitalDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Medical Imaging, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityAbstract Background Degenerative cervical myelopathy (DCM) represents a prevalent etiology of neurological dysfunction, for which cervical decompression surgery (CDS) constitutes the principal therapeutic intervention. Advanced magnetic resonance imaging (MRI) techniques are crucial in elucidating the cerebral alterations associated with neuroinjury resulting from DCM. Methods In this prospective cohort study, we conducted an analysis of data from 54 patients with DCM both before and after surgery, as well as 57 healthy controls (HC), using functional MRI in combination with high-resolution structural MRI. The primary metrics included the z score transformation amplitude of low-frequency fluctuations (zALFF), functional connectivity (FC), and gray matter volume (GMV). Neurological function was evaluated through standardized clinical scores. Statistical analyses were employed to compare preoperative and postoperative changes, as well as to examine correlations with patient recovery outcome. Results Here we show that DCM patients exhibit significant preoperative alterations in zALFF, FC, and GMV within critical brain regions associated with sensory processing, motor control, and cognitive integration. Postoperatively, an increase in zALFF within Postcentral_R region, along with increased FC with motor-related areas, which correlates positively with neurological recovery. Moreover, GMV shows a widespread reduction before and after surgery. Conclusions Our study reveals functional alterations within the brain are closely associated with effective surgical recovery, especially concerning the remodeling of the ascending and descending pathways along the brain–spinal cord axis. Moreover, macrostructural changes manifest more gradually, with the recovery of brain function depending more on compensation and remodeling within neural networks than solely on structural restoration.https://doi.org/10.1038/s43856-025-00909-4
spellingShingle Bingyong Xie
Haoyu Ni
Jiyuan Yao
Zhibin Xu
Sicheng Bian
Haoxiang Wang
Kun Zhu
Xianyong Wu
Peiwen Song
Yuanyuan Wu
Yongqiang Yu
Fulong Dong
Functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgery
Communications Medicine
title Functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgery
title_full Functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgery
title_fullStr Functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgery
title_full_unstemmed Functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgery
title_short Functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgery
title_sort functional and structural brain remodeling in patients with degenerative cervical myelopathy following cervical decompression surgery
url https://doi.org/10.1038/s43856-025-00909-4
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